When Being An Entrepreneur Can Literally Kill You

Overwork went straight to Douglas Heddings' back. The founder of Heddings Property Group in New York City, Heddings has suffered from chronic stress-related back pain for more than a decade.

Even as he recuperated from spine surgery, the pace didn't let up. His inbox filled at the rate of 50 e-mails per hour. The back problem "has a great deal to do with the fact that I feel I have to be on call 24/7," Heddings says.

"This is not good for my mental and physical well-being."

Researchers agree. Frequent long hours can increase stress and touch off a host of health hazards, including insomnia and high blood pressure. Poor decision-making starts to creep in. And unlike your laptop, your system doesn't have an internal fan to cool it down.

A 2006 study at the University of California, Irvine found that chronic work weeks of more than 51 hours can triple the risk of hypertension. And, after looking over the data from a British study of civil servants, Marianna Virtanen of the Finnish Institute of Occupational Health found that workdays of 11 or 12 hours increase the risk of coronary events by 56 percent. Stress is the culprit, triggering the release of hormones that help contribute to plaque build-up inside arteries. Long days were also linked to sleep problems and depression.

Constant work can lead to what the Japanese call karoshi--death by overwork. Researchers in Japan have found a link between long hours, high blood pressure, heart disease and an unhealthy lifestyle--no exercise, sleeplessness, poor eating habits, fewer medical visits and increased anxiety and strain. Sound familiar?

"I get a lot less sleep [than I need]--less than six hours a night," says Katie Danziger, whose New York City-based company, nomie baby, sells parent-sanity-saving washable car seat covers and stroller blankets. Like many overloaded entrepreneurs, Danziger doesn't get any exercise. Instead, she turns all her time over to nomie baby and her three kids.

If you don't take of yourself, you can't take care of your business. But that bit of common sense usually gets trampled by overload and its partner, stress. Stop for a second? Not possible. Delegate? It would take too long to explain the how-tos to a staffer. Take a break to refuel? Too much to do. Shut off the BlackBerry at night? Might miss a sale.

Entrepreneurs are, of course, an action-oriented bunch by definition. That's usually a good thing. But a bias toward action can get in the way of the thinking needed to set limits and work smart. Too many entrepreneurs default to reactive behavior, reflexively jumping to the chime of a new e-mail, the pressure of a ticking clock and other external pressures and interruptions. They let technology and time manage them. This leads to the burnout model of work--they just keep going until the paramedics arrive.

The reality is that no matter how driven you may be, your body wasn't built to take on a 24/7 world. Endless work hours don't lead to increased productivity or innovation. That comes from a rested, refreshed and energized brain. You can get more done in less time when you know when to say when.

Time Out

As the old management-world adage says, work expands to fill the available time. Unless you set boundaries, all of your time becomes available time.

"If someone gets overloaded, fatigued and bombarded with stimuli at all hours, at some point they're going to suffer from decreased cognitive function, fatigue, difficulty concentrating and decreased ability to process information and make decisions," says Dr. Michael Komie, a professor at the Chicago School of Professional Psychology "It's the same as pilots who are over-fatigued." But unlike pilots, there are no rules governing how many hours entrepreneurs can spend working each day

MRI scans of fatigued brains look exactly like ones that are sound asleep. There's not much going on at a certain point of the day. Productivity plummets after eight hours, and stress increases. The only person you really can depend on to keep yourself from trying to get by on the mental faculties of a zombie? That would be you.

Circadian, a Stoneham, Mass.-based work force consulting firm, found that 60-hour work weeks led to a 25 percent reduction in productivity. The reason for the falloff is something we think we can power through: fatigue. But productivity doesn't just dive on the day of the overwork. The fatigue comes out of your hide the next day--and the next. One study found that on the attention and vigilance fronts, medical residents who logged 80-hour weeks have a lot in common with drunk people.

Thanks to an exhausting blend of enthusiasm and drive, it's not unusual for entrepreneurs to slide from compulsive overworker to chronic workaholic. Production becomes the only source of worth. Step back from nonstop output and you feel worthless or guilty. The all-output, all-the-time fallacy makes it difficult to get the time to think and recharge needed for optimum performance.

"Entrepreneurs need to have periods of intense activity, but if it's not balanced out with reflection, relaxation and doing something to take your mind off work, you won't be able to be innovative, creative or find solutions to problems," says Donna De Carolis, associate dean of strategic initiatives at Drexel University's LeBow College of Business in Philadelphia.

The antidote to the overwork treadmill is boundaries. When you set rules for the way you spend your time, you gain control, shed stress and become more satisfied with your work and your life. A Harvard study published in the 2004 book Just Enough by Laura Nash and Howard Stevenson found that the key trait of successful businesspeople who have true satisfaction in their lives is "the deliberate imposition of limits." People who are good at setting boundaries know when they get to the "just enough" point, the authors say.

Not a fan of "just enough?" You're not alone. Letting well enough alone is not a key strength of most entrepreneurs. But unless you draw some lines in the sand--or on your e-calendar--the thrill of determining your destiny can fade quickly. That company you love and would do anything for? While researching overworked executives, Mark Cullen, a professor of internal medicine at Stanford's School of Medicine, found that people end up hating the work they love if they don't set limits on its ownership of their calendar.

The way out of the trap is setting limits--on availability to customers, on portable devices, on the hours you log in a day or week and on contact after-hours and on the weekend.

All Signs Point to "No"

Psychologists say we overestimate the negative effects of saying no. It's colored with the disaster-fueled thoughts of the lower, emotional brain. We also underestimate the cost of saying yes. As Heddings started to set boundaries in the hopes of shedding stress and back pain, "saying no is the thing I've had most difficulty with," he says. "You don't want to lose the client. But I no longer have a problem saying it. When you say it, there's actually more respect."

Without a clear signal of what's out of bounds, everything is in. If you waffle, people assume you're always available. You have to set clear guidelines that everyone can understand--and stick to them. In one week, two clients called Heddings late at night at home. He told them that 10 p.m. doesn't work for him. Each time the client was very apologetic.

"Most of my clients appreciate this, but sometimes it's necessary to fire off a boundary-setting e-mail that explains that we will continue to give incredible service, but we have obligations outside the business that we must also fulfill," he says.

A 2006 study by Amy Edmondson of Harvard Business School and James Detert of Cornell's Johnson Graduate School of Management calls the strategic use of the word no "the improvement-oriented voice process."

Still, Alissa Kraisosky, founder of SummerJasmines, a Riverside, Calif., company that sells foldable sandals, says, "It's hard to see people face to face and say no to them."

And Kraisosky knows how important it is for people to take care of themselves: In addition to running a business, she's also a psychiatrist. That expertise has taught her that self-talk is the key to taking a firm stance. "I tell myself to put my foot down," she says.

The skill you need to break the overwork habit is the same one you use to fuel the achievement track: self-discipline. Deploy your inner disciplinarian to create a work-life perimeter. That line protects your time for your non-work life, family and friends, and allows you to recharge.

Heddings' call to action came from his daughter. After she asked him to put down his BlackBerry and listen to her, he decided to go e-mail-free from 6 to 8 Sunday through Friday nights and all day on Saturdays. The e-mail-free zone now is his favorite part of the day.

Burnout depletes your emotional, physical and mental resources. Time off to refuel builds them back up. You have to recharge (just like a cell phone or iPod). A wealth of research shows that exercise and recreational activities reduce stress, increase positive mood and build social support and vitality, the lifeblood of enterprise. Performance and reaction times increase after vacations and breaks.

"Constant working is detrimental to creativity," De Carolis of Drexel University says. "Creativity requires that we engage in diverse activities, that we relax, that we learn from other people, that we are stimulated.

Creativity is a precursor to innovation. If we want ourselves and our employees to be innovative, we all need time to do things other than work."

And best of all, your business--not to mention your back--will be better for the breaks.

A starter set of rules

Whether you're rule-resistant or just not sure where to start, we've got your back.

Jump-start your new time-protection measures with the following tips and tricks:

Set rules for tools. Turn off the auto- download on your e-mail inbox and smartphone. Instead, check e-mail manually on a set schedule. Researchers recommend a max of four e-mail checks per day. Yes, four. Per day. At night? Turn the e-mail off.

Track your output. Take notes on the ups and downs of your productivity.

A productivity diary will help you learn to recognize when you need to stop.

Shut down and go home. Even if you work from home, mark the end of your workday with a daily ritual--a clear signal that your professional day is behind you. It can be as simple as turning off your computer and the lights, or turning your coffee mug upside down. (Just make sure it's empty first.)

MRI scans of fatigued brains look exactly like ones that are sound asleep. There's not much going on at a certain point of the day. Productivity plummets after eight hours, and stress increases. The only person you really can depend on to keep yourself from trying to get by on the mental faculties of a zombie? That would be you.